Saturday, January 17, 2009

Looking ahead


This is a shout out to my father Jeffrey Wood, who luckily made it to visit me while I was in Dar. Thanks pop, it was a really relaxing good time with you. Thank you for the laptop (on which I am writing this), and for picking out the remnants of sea urchin spines from my right foot. I can't wait for more visitors.

The school year has started more or less. Less than half of our students have arrived by the end of the first week, so hopefully I will actually begin teaching this Monday. There's a lot on my plate so far this year, yet I feel generally calm about the impending kasheshe (your on the net, look it up). Right off the bat, I worked with a very intelligent and interesting computer fundi to fix three of the bum hard disk drives and two of the mother boards (hence 17 computers are now working). It was a very informative experience, as I've never had any training in how to do these things. I'll be the only physics teacher at school for the beginning of this year but with the blessing of the academic office, I've pared down the form three class to 37 students. This means I can teach all four forms--that's twenty-seven periods--without going absolutely batty. Hopefully, other teachers will take more of an interest in the computer lab so that I won't be the sole overseer in the evening sessions. It'd be great to teach the girls how to use microsoft office or open office; get those of them who won't score highly on NECTA better job opportunities. We'll see.

The mushroom project is still going, albeit slowly, as we are waiting for the mycelia to do their magic within our plastic bags stuffed with pasteurized banana leaves. Villagers are still after me to teach more agriculture, which is good and bad, but I'm glad to have become involved in as many communities as I have already. Peace Corps really needs to use my help/recommendations to put some environmental volunteers around here in Mbeya. Trust me, I know peops.

Ok well, as the title of this entry suggests, I'm looking ahead to this, my last year of service in Peace Corps TZ and also to the medical school future I'm working toward. Since I've only gotten a handful of opinions about my writing, I'm going to abuse the eyes of all unwary blogospherians. The following is a recent essay I wrote trying to answer the questions: why do I want to be a doctor and what qualifies me? It's much too long and thoughts meander (as I do too often in my writing), but take a look see anyway.

-Essay-
I consider the diversity of my life experiences to be my number one credit in applying to medical school. Number two is my personal drive to discover new skills and work at perfecting them. And lastly, to borrow a phrase from Melvin Konner, I have basic human competency that exceeds expectation. Even before I decided to become a doctor at the age of 20, the chapters of my life were stacking up to prove that I would excel in a dynamic, challenging field such as medicine. In high school I labored to balance my academics, athletics, and romantic relationships under weight of a video game addiction. Far from excusing my mediocre record, I think that as a physician, I can shed light on the largely misunderstood world of “gamer” culture. And as I continue to become more interested in the neurological and cognitive research, I believe my ability to use technology effectively, and wide variety of media for expression only strengthens my future role as a healer.

From the age of 16 I worked each summer in order to help family finances. My experiences taught me the value of hard-honest work and compassion for the common working men and women who make up the majority of our society. Living and teaching abroad has introduced me to the world of public health, tropical medicine, the battle against HIV/AIDS and the clinic outside the clinic. I have been awed by the automatic credibility ascribed to my (American) education and the color of my skin. Much in the same way, I am sure, that medical students are shocked by the trust that patients invest in the clean white coat or a pair of scrubs. My enduring commitment to living at the fringe of my comfort zone and my insatiable curiosity for life have led me down many roads, and although I plan to specialize into the medical field—a long, difficult road—I see no reason why I cannot continue to be a renaissance man and a forever student.

These were the words that I emphasized on my first day of teaching physics at Kayuki Girls boarding school in Tanzania. When asked how many students were in the room, the quick pupils raced to finish a head count. Invariably, they all came up with one short. I was also a student, I told them, and will be until the day I die. Teaching the subject that gave me the most trouble in College has given me new insights into my learning style and empowered me to become an even stronger scientist. I learn best by teaching. That much I knew when I arrived at my Peace Corps site. So, when I learned that there were no physics teachers at Kayuki, I jumped at the chance to rediscover a physicist within me. Since then, I have rebuilt computers, repaired domestic electrical wiring and appliances, and built countless teaching aids and scientific apparatuses. I have devoured physics and the challenge of algebraic reasoning, and in doing so, apprehended what previously proved difficult.

When I am not teaching at Kayuki, I often work with The Olive branch for Children, an organization based in Toronto that oversees an orphanage and delivers health care and development aid to poverty stricken villages in Mbeya region. Patience and fluent Swahili served me well when we brought a mobile health clinic to the villages. For ten hours, I explained how to safely administer medicines ranging from Vermox and salbutamol to ciprofloxican and sulfanomide to villagers representing several ethnic tribes. Working ten hours a day, while speaking a language that I learned less than a year ago has always been taxing, but always rewarding when, with evening drifting in, children and parents gather to watch a local HIV/AIDS awareness performance troupe. The giggles of children and raucous laughter of the crowd rise and fall in a rhythm that is purely human. In that sense, I know we are all the same. It is the humanity that I frequently appeal to when forging new relationships with people hailing from every conceivable background.

I was probably the most surprised one among the group. Yes, they said, you should be in the running to be our next GCCC president. GCCC stands for Geneseo Chinese Culture Club, and I did become the president for a year despite the minor fact that I am not ethnically Chinese. It was a haphazard leadership experience, and I often appealed to the rest of the executive board members for help in identifying important events to showcase, and which holidays to observe. Although I might have done a better job as leader, my chief contribution to China Night, the annual dinner and show put on by our club, was a smashing success. For weeks, I had worked to choreograph and teach a kung fu dance based on monkey style pole. Twirling long staves and whipping high-kicks wowed the audience and gave me a satisfaction that kept me elated amidst the stress of overseeing a two hour enactment of the Monkey King. It was my ability to speak diplomatically and on the spot that kept the audience placated during a long delay between the welcome speech and the opening act. This skill came to play in China, as an English teacher and at work in the Asian Restaurant in Boston where I was expected to be cordial but efficient. My service in Africa, likewise, has become full of rewarding relationships. One such relationship changed the way I view a doctor’s role and responsibilities forever.

My mind froze when I first saw her. Stiff-legged—toes pointed almost gracefully, her unfocused eyes scanning the room from beneath her bulging skull—Sylvia sat on the floor. I slowly became self-conscious of my hesitation at the doorway and entered the room. Momentary disbelief caught me wondering how the bones of the cranium can appear to be unfurling like bone flower petals and still constitute the head of a little girl. I held the Sylvia’s hand and tried to understand what little tribal language that she spoke in broken repeats. It pained me to see her loop through it again and again, but her periodic smiles and laughs reminded me that she was almost like any other five-year-old except for her hydrocephalus. Despite my initial uneasiness, as I continually interacted with Sylvia my resolve to become a physician only grew.

At times I struggled, left alone with Sylvia, while her mother tended to the household chores and her son. Sylvia’s mental faculty is limited, but I discovered the soothing power of music could improve her mood. On some occasions, I would change her little gown, wet with urine. Other times, I blew air over her feverish back in the attempt to calm her in a manner that I learned from my mother when I was a five year old. Unfortunately, in my estimation, these attempts to help Sylvia fell terribly short of sufficient. With limited resources, I began to research hydrocephalus shortly after meeting Sylvia. I found that another little girl living mere miles away also had hydrocephalus. Debo as she was called, the daughter of a guard at my school, had a shunt installed by a visiting European doctor when she was one year old. However, when I met her, it was clear that her condition was not favorable. Open sores on her head festered along the path of the plastic tube running under her scalp and down to her abdomen. I cautioned the parents about keeping Debo clean and recommended that they see a doctor, since the shunt had broken the skin. Two weeks later, I was informed that Debo had died. Her parents had lacked the money to bring her to a hospital where she could be treated. Her death was a sad result despite good intentions and economic hardship. I realized that the shunt that was meant to save her life, by relieving pressure on her brain could have been the immediate cause of her demise. Shunts often become clogged, and in an unhygienic environment, become as much a danger as a boon. I couldn’t fathom the prognosis that a doctor formulated in which a two-year-old in rural Tanzania would have a plastic tube implanted into her body and then return to the hospital (an eight hour trip) every three months for monitoring. On the other hand, I couldn’t find it in me to place blame. If pressure continues to increase within the cranium until the brainstem becomes compressed, there would be a funeral much sooner than if infection takes hold. A western doctor had chosen to install the shunt. Complications of living poor and Tanzanian had twisted the outcome. And yet, I wonder, if foresight had been keener would Debo still be alive? There must be a way to plan treatments to better serve low income, patients with adverse lifestyles. What would Paul Farmer do? He would have given the family the money to make frequent trips or he would have kept her at the hospital. Would he decide against surgery? Trying to imagine myself as a physician dealing with Debo’s case, knowing what I know about how economic factors in medical care affect patient outcomes even more than treatment, I may have preferred to forgo surgery. But I have had no training. I only know that good medical care requires integrative conceptualization of a human being, their situation in life.

As a researcher in cell biology, I learned important biochemical techniques. I also became the most proficient user of the new Epiflouresence microscope at my school. Although my research did not yield a publication, my advisor was truly impressed with my skill on the microscope, using integrated computer software to take multi-layer pictures of mitotic spindles in brewer’s yeast. It was a new project, but I was not afraid to build it from the ground up, and improve the school’s capacity to work with and excellent model organism, S. cerevisiae. Since college, I have become more interested in research and plan to engage in head-start research programs available at many medical schools. In particular, research in neurological science is attractive to me.

One of my earliest memories is of me trying to dissect a road-kill garter snake with a serrated steak knife. At the age of three and a half, I was scolded by my mother for dirtying a good knife, but I learned an important lesson. Bodies are too hard to explore with the wrong tools, but much too soft when confronted with a speeding pickup truck. Looking back on the richness of my life experiences, I see that even if I discovered my path toward medicine late in life, my character and skills will make me into a world-class practitioner of medicine.